Abstract Background and Aims Targeting the renal sodium phosphate cotransporter 2a (Npt2a) offers a novel strategy for treating hyperphosphatemia in chronic kidney disease (CKD). In patients with and without reduced kidney function, hyperphosphatemia is associated with cardiovascular complications and currently treatment options are limited. Method To study the role of a novel Npt2a inhibitor (PF-06869206) we used in vitro (Opossum kidney [OK] cells) and in vivo approaches (C57Bl/6 and Npt2a knockout [Npt2a−/−] mice). As models of CKD, 5/6 nephrectomy (5/6 Nx) as well as novel Alport/Npt2a knockout mice (Alport/Npt2a−/−) were studied. Results OK cell experiments showed that the Npt2a inhibitor caused dose-dependent reductions of Na+-dependent Pi uptake (IC50: ∼1.4 μmol/L) and Michaelis-Menten kinetics identified a ∼2.4-fold higher Km for Pi in response to Npt2a inhibition with no significant change in apparent Vmax, indicating a competitive mode of action. In vivo, Npt2a inhibition enhanced urinary excretions of Pi, Ca2+, and Na+ dose-dependently, which is recapitulated in animal models with reduced kidney function (5/6 Nx and Alport mice). Reductions in plasma Pi occur within 30 minutes and reach a maximum (40-50%) after 2 hours, this coincided with ∼50% reductions in PTH levels. No effects on FGF23 were observed in this time frame. In C57Bl/6 mice qualitative immunohistochemistry after 24 hours showed reductions in Npt2a labelling in apical microvilli compared to vehicle treatment. Providing proof of concept, Npt2a−/− and Alport/Npt2a−/− mice confirmed specificity of the drug, effects on urinary and plasma Pi were absent. Further electrophysiological studies in acutely isolated connecting tubule/cortical collecting duct showed that open probability of the epithelial Na+ channel (ENaC) was reduced in response to Npt2a inhibition, suggesting that the natriuretic effect is mediated, at least in part, by inhibition of ENaC. Conclusion Npt2a inhibition offers a promising therapeutic approach for treating hyperphosphatemia and possibly offers the opportunity of reducing cardiovascular complications in CKD.